Tolerance lowering in jail = overdose on release?

[Cakes]

I was wondering if tolerance levels lower in different ways dependent on drug.

I read that released inmates suffer extremely high fatal overdose rates for their first two weeks out*. I wonder if some of these folks are forgetting their tolerance may have lowered.

Do different drugs act differently in this regard? I mean does Mr. Newly Released have to build up all over again to previous dose levels? or can he do a "full" shot of one drug but not another?

*http://www.medpagetoday.com/Infectio...Health/tb/4839

[Panthers007]

Not only are released prisoners at an elevated risk for ODing and death, but anyone who stops for any reason. Like being in a coma for a month. This applies to primarily the narcotics - such as heroin and oxycodone. What prior to stopping would be enough to keep withdrawls at bay, may be a lethal overdose. One would hope that anyone who was addicted to these drugs would know this. But no accounting for Darwin...

Reputation Comments on this post:

Thanks for this post, i needed that info.

[Junket]

Originally Posted by Cakes

I was wondering if tolerance levels lower in different ways dependent on drug.

I read that released inmates suffer extremely high fatal overdose rates for their first two weeks out*. I wonder if some of these folks are forgetting their tolerance may have lowered.

Do different drugs act differently in this regard? I mean does Mr. Newly Released have to build up all over again to previous dose levels? or can he do a "full" shot of one drug but not another?

*http://www.medpagetoday.com/Infectio...Health/tb/4839

Are you going to jail soon?

Physically your tolerance will have gone down. But mentally you still have a tolerance, like you know what to expect and its not a new experience by any means. Which can lead some people to believe they're fine when maybe they aren't...

Or maybe inmates fresh out of jail are probably just celebrating and going crazy. They are out to get fucked up.

Reputation Comments on this post:

good point about familiarity being a part of integration. but and please use SWIM.

[Cakes]

I have been to jail a few times since you asked. but of course i would never shoot up illegal drugs. you should review the rules to see how using SWIM avoids giving people the wrong impression about what goes on around here.

My interest lies in the fact that knowledge of these issues could avoid many tragedies.

One would hope that anyone who was addicted to these drugs would know this.

addiction could imply they have never stopped yet.

And the fact that it can vary from drug to drug could be QUITE misleading.

Not only are released prisoners at an elevated risk for ODing and death, but anyone who stops for any reason. Like being in a coma for a month. This applies to primarily the narcotics - such as heroin and oxycodone. What prior to stopping would be enough to keep withdrawls at bay, may be a lethal overdose.

Thank you very much for this. I plan to post this info at a website for family of inmates (prisontalk.com).

[RoboCodeine7610]

I think the above posts cover it, but yeah tolerance,specially to opioids develops really quickly and goes down just as quick...
So inmates go out and use the same dose they used when they had a high tolerance, and consequently overdose...

Reputation Comments on this post:

thanks for SWIY's knowledge.

[Cakes]

So it's not really true with meth?

[elpatto]

SWIM thinks it might just be easier to find out with a less irreversible (sp) method, such as smoking heroin or meth, at a ammount that before wouldnt have been to serios a high.
Just to be sure that SWIY does'nt IV up a nice hit of comatose or something.

SWIM never realy stopped for a extended period, but at the same time never had what one would call a full blown addiction, in referance to hard drugs anyway. SWIM can tell you that after 2 months in the US his drinking tolerance is down alot, around 6-8 cans for intoxication as opposed to 15+ stronger and bigger cans. I Guess SWIM bulked up a alcohol tolerance reserved normally for Irish fishermen after drinking heavily, on a daily basis for the last 2 years, and on a weekly/bi-weekly basis since he was 12.

P.S. Is it necessarry to use SWIM when talking about alcohol? Better safe then sorry but it's not a illegal substance, and I would be happy to rave about alcoholism and should'nt have to say SWIM, SWIY an such .
Peace

Reputation Comments on this post:

good points.

[Cakes]

see? that's another couple of decent suggestions. it does make sense that some dudes can probably put away coma-type amounts of alcohol.

P.S. Is it necessarry to use SWIM when talking about alcohol?

Seems nice to use it at all times so newbies do not get the wrong idea should they surf such a page first.

[HorseBucket]

Swims dad tells him he got out of jail one day and his friends picked him up but he wanted a hit of heroin so took one right there in the parking lot but he didn't take his low tolerance into consideration and OD'd right there in the jail parking lot.

Reputation Comments on this post:

good illustration

[Cakes]

[Junket]

Originally Posted by HorseBucket

Swims dad tells him he got out of jail one day and his friends picked him up but he wanted a hit of heroin so took one right there in the parking lot but he didn't take his low tolerance into consideration and OD'd right there in the jail parking lot.

in the jail parking lot? jesus..

maybe they should give inmates some drug use 101

[Cakes]

absolutely. should be an elective course at school too.

[Junket]

haha.. its already alot of students extra curricular activity so why not?

DARE is bullshit. we all know this

[RoboCodeine7610]

I mean, they're already doing all that needle exchange shit, how hard would it be to get all inmates in a room and tel them:
When banging smack after you get out of here REMEMBER YOUR FUCKING TOLERANCE!
It could save lives...

[Cakes]

maybe it WOULD be as easy as writing to the director of health programs and telling him to add it to the lecture sheet.

dear so and so,

we have noticed that x amount of inmates die from OD on release. we believe many of those incidents are accidents due to users forgetting they have lost tolerance to drugs. we feel all those fatalities could be avoided by a simple warning issued by the existing health system during routine contact.

thank you very much,

concerned citizen

[RoboCodeine7610]

Originally Posted by Cakes

maybe it WOULD be as easy as writing to the director of health programs and telling him to add it to the lecture sheet.

dear so and so,

we have noticed that x amount of inmates die from OD on release. we believe many of those incidents are accidents due to users forgetting they have lost tolerance to drugs. we feel all those fatalities could be avoided by a simple warning issued by the existing health system during routine contact.

thank you very much,

concerned citizen

Don't you know that the government WANTS them dead? That's why they never say anything...
They're just trying to kill as many drug users as possible...Shit's crazy, FUCK THE GOVENMENT! FUCK YOU ALL!!

Reputation Comments on this post:

thanks for the input. and ps, it is against the rules to sign ur name to rep statements.

[Cakes]

soapbox.gif

well, we sent the following to the medical director of the bop anyway.
use the flyer to send ur own gov if u want .

We have read that inmates face a very high risk of drug overdose following release from prison. We believe this may be due to inmates being unaware their tolerance to drugs has lowered. We think all of these fatalities could be avoided by a simple warning issued by the existing health care system during routine contact. We think that the attached flyer or one like it should be issued to all incarcerated persons and residents of drug treatment centers.

link to study showing elevated overdose risk:
http://content.nejm.org/cgi/content/abstract/356/2/157

Thank you very much. and also, we would appreciate being told of any action taken on this issue.

Sincerely,

Cakes Downey and Friends

Reputation Comments on this post:

	Very nicely done. Do distribute this!
	:)

[RoboCodeine7610]

Did you seriously send that?
Cool, but were exactly did yo send it to?

[Panthers007]

Excellent warning-sheet, Cakes! The quality of the illustration could use a bit of help - LOL! But excellent! Send it on. Then if the powers-that-be reject it, we'll know that RoboCodeine is correct. Then use that bit of information as leverage to force it to be distributed.

[enquirewithin]

Like the illustration! That was what happened to Sid Vicious.

[He] was clean, having been weaned off heroin during his time at Rikers Island jail. However, at the dinner gathering, he obtained some heroin and that night he overdosed.

[Cakes]

Did it? that sucks. According to the study, this info could save about 129 people for every 30,000 released.

exactly did yo send it to?

The medical director of the Bureau of Prisons. he is the guy in charge of the US federal prison system. That means it still could use distribution to the US state systems (but i do have that contact info) and internationally (i do not have that info).

Then use that bit of information as leverage

That's my boy!

Cakes added 927 Minutes and 58 Seconds later...

i guess this post will be automerged but oh well.

a leveraged update..we rewrote the letter and sent it to all US State and Territory Health Departments. not only better coverage like 007 suggested but also a warden would be quicker to toss my flyer than one sent by the Health Department.

new letter:

We think that the attached flyer or one like it should be issued to all state/county inmates and other applicable parties. We have read that inmates face a very high risk of drug overdose following release. We believe this may be due to people being unaware their tolerance to drugs may have lowered. We think all of these fatalities could be avoided by a simple warning issued by the existing health care system during routine contact. Besides inmates, others at risk would be people who have been hospitalized for extended periods, on away missions, in treatment centers and first time addicts. Dissemination through the DARE programs and public health clinics may be a good idea.

link to study showing elevated overdose risk:
http://content.nejm.org/cgi/content/abstract/356/2/157

Thank you very much. and also, we would appreciate being told of any action taken on this issue.

Sincerely,

Cakes Downey and Friends

Don't you know that the government WANTS them dead?

The Mission of the Georgia Department of Corrections, Office of Health Services, is to provide the required constitutional level of health care in the most efficient, cost effective and humane manner possible, while protecting the public health interests of the citizens of the State of Georgia.

[RoboCodeine7610]

The Mission of the Georgia Department of Corrections, Office of Health Services, is to provide the required constitutional level of health care in the most efficient, cost effective and humane manner possible, while protecting the public health interests of the citizens of the State of Georgia.

hahaahahahahahaha yeah right

[Cakes]

key word>>while

that state does not provide any public defenders for criminal court even though their legislature mandated it a couple decades ago.

The news looks better from Massachoosit although they are the only ones to reply so far out of the 73 emails i have sent:

Thanks for your thoughtful note and good suggestion to work on the issue of prisoner vulnerability when their tolerance is r edu ced due to incarceration. We have been aware of this issue for quite a while and have responded by conducting a pilot nasal Narcan project in which we teach drug users, their friends and families and people who work with them, to recognize an overdose, to call 911, to begin rescue breathing and to administer nasal Narcan to reverse the OD. We have been able to work in several houses of corrections to do the OD training behind the walls and to teach people where to go once they are released. Our pilot program began in January, 2008 and to date, we have trained over 1,000 people and they have reversed 132 overdoses.

This is still a pilot project but we are intent on making this statewide since it has been so successful with no adverse effects.

I liked your cartoon flier and will share it with the people in our substance abuse and AIDS bureaus. Thanks for your thoughtful comments. We have seen a tremendous increase in fatal opiate ODs and are responding to this directly.

Best regards,

Andy Epstein, RN, MPH
Special Assistant to the Commissioner
MDPH
250 Washington Street, Boston 11208
tel:617 624-5242 fax 617 624-5206

so Congratulations everybody! you've done good.

i was doing a little number crunching and if u take the number of people now incarcerated in the US and do math on it with the number of people that may be dying from accidental OD, you get about 10,000. so and that doesn't count the number of ones that go to jail just for a short time and it doesn't count people that are not incarcerated or the ones who are not in the US. it would be a decent sized gathering.

Cakes added 115 Minutes and 27 Seconds later...

ah, my Dear 007, how is this for a leveraged response:

We sent to:

Nicholas A. Toumpas, Commissioner of the Department of Health, New Hampshire

who forwarded it to:

Bureau of Drug and Alcohol

who forwarded it to:

NH Department of Corrections and the County Houses of Corrections

[Cakes]

and another one:

I am forwarding to our Dept of Correction Commissioner as well.

Tami Barrett
Indiana State Dept. of Health
2 North Meridian Street
Indianapolis, IN 46204
Phone: 317/233-7400
Fax: 317/233-7387
tbarret @ ish.in.gov

Reputation Comments on this post:

Great work.

[Panthers007]

Good job, my dear Cakes! Keep on truckin'!